Delirium and Dementia: A Comprehensive Guide

What is Delirium?

Delirium is a disturbance of consciousness and cognitive function that develops rapidly, usually over hours or days. It is characterized by:

• Impaired attention and concentration
• Disorganized thinking
• Memory problems
• Hallucinations or delusions

What is Dementia?

Dementia is a decline in cognitive function that worsens over time and interferes with daily activities. It is characterized by:

• Memory loss
• Impaired judgment
• Difficulty with language
• Changes in behavior and personality

DSM-IV and DSM-5 Criteria for Dementia

The Diagnostic and Statistical Manual of Mental Disorders (DSM) provides criteria for diagnosing dementia. The DSM-IV and DSM-5 criteria are similar, but the DSM-5 has some key changes:

• The DSM-5 requires that cognitive impairment must interfere with daily activities.
• The DSM-5 allows for a diagnosis of dementia even if the person has not experienced a decline in social or occupational functioning.
• The DSM-5 provides specific criteria for different types of dementia, such as Alzheimer's disease and vascular dementia.

Drugs that Cause or Prolong Delirium or Confusional States

Certain drugs can cause or prolong delirium or confusional states. These drugs include:

• Anticholinergics
• Antidepressants
• Antipsychotics
• Benzodiazepines
• Opioids

PHQ-2 Questionnaire

The PHQ-2 questionnaire is a two-item screening tool for depression. It is commonly used in clinical settings to identify people who may be at risk for depression.

Regional Atrophy

Regional atrophy refers to a loss of volume in specific brain regions. It can be a sign of neurodegenerative disorders, such as Alzheimer's disease and frontotemporal dementia.

Brain MRI including FLAIR and DWI with and without gadolinium enhancement

Magnetic resonance imaging (MRI) is a medical imaging technique that uses a strong magnetic field and radio waves to produce detailed images of the brain. FLAIR (fluid-attenuated inversion recovery) and DWI (diffusion-weighted imaging) are MRI sequences that can help visualize different types of brain tissue. Gadolinium enhancement can be used to highlight blood vessels in the brain.

Rapidly Progressive Dementias (RPDs)

RPDs are a group of disorders that cause a rapid decline in cognitive function, leading to dementia within a relatively short time. RPDs can be caused by a variety of factors, including:

• Immune-mediated encephalopathies
• Infectious encephalopathies
• Metabolic encephalopathies